Array Dental Group, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ARRAY DENTAL GROUP, LLC

Practice address

5058 Dorsey Hall Dr Ste 102
Ellicott City, MD 21042-7850

Phone

(410) 304-7226

NPI assigned

Sep 21, 2021

Last updated

Sep 21, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Gallagher

Title

Chief Executive Officer

Phone

(240) 755-0167

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1609547694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9841 BROKEN LAND PKWY STE 107",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463059",
            "telephone_number": "240-755-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5058 DORSEY HALL DR STE 102",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427850",
            "telephone_number": "410-304-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARRAY DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "240-755-0167"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.